doc983 kB 21st May 2014 NationalFormulary
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983 kB 21st May 2014 NationalFormulary
KEEPING HEALTH CARE BENEFITS AFFORDABLE WITH “FORMULARY” COVERAGE Of all the products and services covered under your Chambers of Commerce Group Insurance Plan® health care benefit, prescription drug costs account for 70¢ of every claim dollar. One successful way to manage increasing costs is through the use of a Formulary. The Chambers Plan offers the TELUS Health Solutions National Formulary as part of some health coverage options. While we offer a wide range of health care options, we recommend you seriously consider whether a Formulary option can work for you! WHAT IS A FORMULARY? A formulary is an actively managed, evolving list defining the prescription drugs to be covered under your company’s benefit program. The list is designed to minimize the impact of rising drug costs by covering only drugs that are both medicinally effective and cost effective. For years now, Canadian hospitals and provincial drug plans have used formularies successfully. TELUS Health Solutions operates the largest private electronic insurance claims network in Canada. With continued input from ReVue, an independent committee of physicians and pharmacists, TELUS Health Solutions constantly reviews the items included in the National Formulary based on their quality and cost. The list is kept current through the addition, deletion or replacement of drugs to ensure plan members have access to quality drug therapies. The National Formulary covers 80% of the most frequently prescribed drugs. Drugs on the list are chosen for their cost and therapeutic values. That means new medications are routinely considered for the list but not automatically covered. WHY ARE DRUG PLAN COSTS RISING? DEMOGRAPHICS – Our population is aging and as people age they tend to use more medications. Drugs listed on the Formulary: 70% TO 100% OF THE COST IS COVERED (BASED ON PLAN DESIGN) Drugs NOT listed on the Formulary: 50% OF THE COST IS COVERED WHAT IF MY PRESCRIPTION IS NOT LISTED ON THE NATIONAL FORMULARY? Under our Formulary plans, we cover at least 50% of the cost of all eligible drugs. If the drug your physician prescribes is not on the Formulary, a ‘therapeutic alternative’ providing similar treatment likely will be. With your doctor’s advice, you have two options: you can ask your doctor to prescribe the drug that is on the formulary, covered at 70% to 100% (based on plan design), or you can fill the unlisted prescription and claim 50% of its cost. In either case, your benefit plan still pays a significant portion of the expense to help you with the cost of your prescription. NEW DRUGS – Innovative treatment options replacing older less effective therapies or providing treatment alternatives for certain conditions are generally more expensive than the drugs they are replacing. HOW WILL MY DOCTOR KNOW WHAT TO PRESCRIBE? PROMOTIONAL SPENDING – Over the past decade we’ve seen an increase in the advertising and promotion of the availability of newer medications. The ads have increased the awareness of the options available, and at the same time increased consumer’s expectations. The list on the following pages provides a quick overview of the most frequently prescribed medications. Although it is only a partial list, it shows many drugs on the Formulary and covered at the higher co-insurance percentage, and others not included on the Formulary but still covered at 50%. DOCTORS’ HEALTH LINE Tell your doctor your drug benefit program uses the TELUS Health Solutions National Formulary. Physicians are familiar with these types of plans. DOCTORS WHO WANT ADDITIONAL OR MORE SPECIFIC INFORMATION ARE WELCOME TO CALL TELUS HEALTH SOLUTIONS TOLL-FREE AT 1 888 668 1330 This service centre can confirm whether or not a particular prescription falls under the National Formulary. THIS PARTIAL LIST OF THE MOST FREQUENTLY DISPENSED MEDICATIONS LETS YOU SAMPLE THE FORMULARY’S COVERAGE. “YES” MEANS THE DIN IS COVERED AT THE HIGHER CO-INSURANCE PERCENTAGE. DIN Name 00021474 00021695 00037605 00312770 00326844 00335053 00335061 00335088 00362166 00396788 00402796 00402818 00406716 00445282 00452130 00479799 00509558 00585114 00586668 00589861 00592277 00608165 00609129 00613215 00628123 00628158 00637742 00642215 00648035 00653276 00655759 00700401 00716626 00716839 00733059 00749354 00768715 00821772 00885436 00999999 01900978 01912070 02028700 02029421 02031094 02041421 02041456 02041464 02042479 02042487 02043394 02043408 02043440 02063662 02123274 02123282 02144263 02147637 02148587 02148765 02155907 02155990 02163926 NOVO-HYDRAZIDE 25MG TABLET NOVO-PREDNISONE 5MG TABLET MICRONOR 0.35MG 28 TABLET APO-PREDNISONE 5MG TABLET APO-HYDRO 25MG TABLET ELAVIL 10MG TABLET ELAVIL 25MG TABLET ELAVIL 50MG TABLET APO-FUROSEMIDE 40MG TABLET APO-FUROSEMIDE 20MG TABLET ZYLOPRIM 300MG TABLET ZYLOPRIM 100MG TABLET NOVAMOXIN 500MG CAPSULE APO-SULFATRIM DS TABLET NOVAMOXIN 250MG/5ML SUSP ZYLOPRIM 200MG TABLET EPIPEN 0.3MG AUTO-INJECTOR APO-IBUPROFEN 600MG TABLET FUCIDIN 2% CREAM TEVA-NAPROX 500MG TABLET APO-NAPROXEN 500MG TABLET RATIO-OXYCOCET TABLET DICLECTIN TABLET TEVA-SPIRONOLACTONE 25MG TABLET APO-AMOXI 500MG CAPSULE APO-AMOXI 250/5ML ORAL SUSPENSION NOVO-LORAZEM 1MG TABLET APO-PEN-VK 300MG TABLET TEVA-METOPROL 50MG CAPLET RATIO-LENOLTEC NO.3 TABLET APO-LORAZEPAM 1MG TABLET RATIO-PREDNISOLONE 1% EYE DROPS BETADERM 0.1% CREAM HYDERM 1% CREAM APO-RANITIDINE 150MG TABLET APO-METOPROLOL (TYPE L)50MG APO-CEPHALEX 500MG TABLET D-TABS 10000IU TABLET PMS-HYDROMORPHONE 2MG TABLET EXTEMPORANEOUS MIXTURES REACTINE 20MG TABLET RATIO-DOMPERIDONE 10MG TABLET TRI-CYCLEN 21 TABLET TRI-CYCLEN 28 TABLET LAMISIL 1% CREAM ATIVAN 1MG TABLET ATIVAN 0.5MG TABLET SL ATIVAN 1MG TABLET SL MARVELON 28 TABLET MARVELON 21 TABLET PREMARIN 0.3MG TABLET PREMARIN 0.625MG TABLET PREMARIN VAGINAL CREAM/APPL MACROBID 100MG CAPSULE COVERSYL 2MG TABLET COVERSYL 4MG TABLET TEVA-TRAZODONE 50MG TABLET APO-TRAZODONE 50MG TABLET ESTRACE 1MG TABLET MYLAN-METFORMIN 500MG TABLET ADALAT XL 30MG TABLET ADALAT XL 60MG TABLET TYLENOL W/CODEINE NO. 3 TABLET Listed Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y 50% Y Y Y Y Y Y Y Y Y Y Y Y Y Y 50% Y Y 50% Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y DIN Name Listed 02166704 02167786 02171228 02172062 02172070 02172089 02172097 02172100 02172119 02172127 02172135 02177145 02182963 02207818 02213192 02213206 02213214 02218313 02229453 02229705 02229777 02229837 02230711 02230713 02231353 02232044 02233542 02233852 02236974 02236975 02237452 02237600 02238465 02238545 02238578 02238596 02238682 02238704 02239941 02239942 02240606 02240836 02240837 02241497 02242965 02242974 02242987 02243158 02244021 02244292 02244293 02244353 02244522 02244613 02244756 02245058 02245127 02245233 02245386 02245669 02246010 02246056 02246569 PROMETRIUM 100MG CAPSULE Y APO-METFORMIN 500MG TABLET Y SYNTHROID 0.112MG TABLET Y SYNTHROID 0.025MG TABLET Y SYNTHROID 0.05MG TABLET Y SYNTHROID 0.075MG TABLET Y SYNTHROID 0.088MG TABLET Y SYNTHROID 0.1MG TABLET Y SYNTHROID 0.125MG TABLET Y SYNTHROID 0.15MG TABLET Y SYNTHROID 0.175MG TABLET Y APO-CYCLOBENZAPRINE 10MG TABLET Y APO-METHOTREXATE 2.5MG TABLET Y PMS-CLONAZEPAM R 0.5MG TABLET Y ELTROXIN 50MCG TABLET Y ELTROXIN 100MCG TABLET Y ELTROXIN 150MCG TABLET Y APO-ZOPICLONE 7.5MG TABLET 50% PANTOLOC 40MG TABLET 50% HUMALOG INSULIN CARTRIDGE/KWIKPEN Y PMS-BENZYDAMINE ORAL RINSE 50% ARTHROTEC 75/200MCG TABLET Y LIPITOR 10MG TABLET Y LIPITOR 20MG TABLET Y MYLAN-CYCLOBENZAPRINE 10MG TABLET Y ARICEPT 10MG TABLET 50% DIANE-35 2MG/35MCG TABLET 50% SYNTHROID 137MCG TABLET Y ALESSE 21 TABLET Y ALESSE 28 TABLET Y PERIDEX 0.12% ORAL RINSE 50% PMS-ATENOLOL 50MG TABLET Y NASONEX AQ. NASAL SPRAY 50MCG Y ASAPHEN 80MG EC TABLET Y FUCIDIN H CREAM Skin disorders Y MYLAN-ZOPICLONE 7.5MG TABLET 50% PLAVIX 75MG TABLET Y ESTROGEL .06% TRANSDERMAL GEL 50% CELEBREX 100MG CAPSULE 50% CELEBREX 200MG CAPSULE 50% PMS-ZOPICLONE 7.5MG TABLET 50% ADVAIR 250UG INHALATION DISKUS Y ADVAIR 500UG INHALATION DISKUS Y VENTOLIN HFA 100MCG INHALER Y AVELOX 400MG TABLET 50% RATIO-METFORMIN 500MG TABLET Y DIAMICRON MR 30MG TABLET 50% CLINDOXYL 1% TOPICAL GEL Y ATACAND PLUS 16/12.5MG TABLET Y FLOVENT HFA 125MCG INHALER (AEROSOL) Y FLOVENT HFA 250MCG INHALER (AEROSOL) Y NOVORAPID 100U/ML INSULIN CARTRIDGE Y NEXIUM 40MG TABLET 50% DETROL LA 4MG SR CAPSULE 50% BIAXIN 500MG XL TABLET Y APO-OMEPRAZOLE 20MG DR CAPSULE 50% ADVAIR 250MCG MD INHALER Y APO-CLINDAMYCIN 300MG CAPSULE Y SYMBICORT 200 TURBUHALER Y APO-SALVENT CFC FREE INHALER Y APO-METOPROLOL 25MG TABLET Y APO-CITALOPRAM 20MG TABLET Y COVERSYL PLUS 4MG/1.25MG TABLET 50% THIS PARTIAL LIST OF THE MOST FREQUENTLY DISPENSED MEDICATIONS LETS YOU SAMPLE THE FORMULARY’S COVERAGE. “YES” MEANS THE DIN IS COVERED AT THE HIGHER CO-INSURANCE PERCENTAGE. DIN Name 02246624 02246691 02246793 02246820 02247162 02247163 02247439 02247521 02247733 02247734 02247813 02247919 02248010 02248562 02248855 02250497 02251582 02251930 02252260 02252716 02252767 02253186 02255340 02256134 02257726 02258560 02258587 02261723 02261731 02263238 02263254 02265540 02267233 02268426 02268434 02268450 02269082 02270102 02271842 02272113 02273373 02273381 02274086 COVERSYL 8MG TABLET Y APO-HYDROXYQUINE 200MG TABLET Y SPIRIVA 18MCG CAPSULE Y SANDOZ METFORMIN 500MG TABLET Y CRESTOR 10MG TABLET Y CRESTOR 20MG TABLET Y SANDOZ BISOPROLOL 5MG TABLET Y EZETROL 10MG TABLET 50% CONCERTA 36MG ER TABLET 50% CONCERTA 54MG ER TABLET 50% AVODART 0.5MG CAPSULE 50% PMS-RAMIPRIL 10MG CAPSULE Y PMS-CITALOPRAM 20MG TABLET Y METRONIDAZOLE 500MG CAPSULE Y PMS-METOPROLOL-L 25MG TABLET Y TEVA-AMLODIPINE 5MG TABLET Y APO-RAMIPRIL 10MG CAPSULE Y LANTUS 100U/ML INSULIN CARTRIDGE Y VIGAMOX 0.5% OPH SOLUTION 50% CIPRODEX OTIC SUSPENSION Y APO-CLOPIDOGREL 75MG TABLET Y NUVARING VAGINAL RING 50% CO-AZITHROMYCIN 250MG TABLET Y APO-BISOPROLOL 5MG TABLET Y CO-METFORMIN 500MG TABLET Y TRI-CYCLEN LO 21 TABLET Y TRI-CYCLEN LO 28 TABLET Y YASMIN 21 TABLET Y YASMIN 28 TABLET Y CIPRALEX 10MG TABLET Y CIPRALEX 20MG TABLET Y CRESTOR 5MG TABLET Y TECTA 40MG EC TABLET 50% LYRICA 50MG CAPSULE Y LYRICA 75MG CAPSULE Y LYRICA 150MG CAPSULE Y LIPIDIL EZ 145MG TABLET Y FLOMAX 0.4MG CR TABLET Y LEVEMIR PENFILL Y MYLAN-AMLODIPINE 5MG TABLET Y APO-AMLODIPINE 5MG TABLET Y APO-AMLODIPINE 10MG TABLET Y PMS-HYDROCHLOROTHIAZIDE 12.5MG TABLET Y TEVA-VENLAFAXINE XR 37.5MG ER CAPSULE Y TEVA-VENLAFAXINE XR 75MG ER CAPSULE Y TEVA-VENLAFAXINE XR 150MG ER CAPSULE Y WELLBUTRIN XL 150MG TABLET Y WELLBUTRIN XL 300MG TABLET Y NOVO-BETAHISTINE 16MG TABLET Y TEVA-LANSOPRAZOLE 30MG CAPSULE 50% ZOPICLONE 7.5MG TABLET 50% PMS-AMLODIPINE 5MG TABLET Y TEVA-PANTOPRAZOLE 40MG TABLET 50% APO-PANTOPRAZOLE 40MG TABLET 50% APO-LANSOPRAZOLE 30MG CAPSULE 50% LANTUS SOLOSTAR 100U/ML PREFILL PEN 5X3ML Y APO-ATORVASTATIN 10MG TABLET Y APO-ATORVASTATIN 20MG TABLET Y APO-ATORVASTATIN 40MG TABLET Y APO-ATORVASTATIN 80MG TABLET Y 02275023 02275031 02275058 02275090 02275104 02280191 02280523 02282445 02284065 02285487 02292920 02293838 02294338 02295261 02295288 02295296 02295318 FORMULARY-03-13 Listed DIN Name 02296640 02297795 TEVA-RABEPRAZOLE EC 20MG TABLET GLICLAZIDE MR 30MG EXTENDED RELEASE TABLET RAN-RABEPRAZOLE 20MG EC TABLET TEVA-RISEDRONATE 35MG TABLET PMS-VALACYCLOVIR 500MG TABLET AVIANE 21 TABLET AVIANE 28 TABLET AVAMYS 27.5MCG NASAL SPRAY SANDOZ PANTOPRAZOLE 40MG TABLET CYMBALTA 30MG DR CAPSULE CYMBALTA 60MG DR CAPSULE OMNARIS 50MCG NASAL SPRAY JANUVIA 100MG TABLET RAN-PANTOPRAZOLE 40MG TABLET RAN-RAMIPRIL 5MG CAPSULE RAN-RAMIPRIL 10MG CAPSULE SANDOZ-RABEPRAZOLE 20MG TABLET PRO-METFORMIN 500MG TABLET PMS-CETIRIZINE 20MG TABLET PANTOPRAZOLE 40MG TABLET PRISTIQ 50MG ER TABLET YAZ TABLET COVERSYL PLUS HD 8MG/2.5MG TABLET VAGIFEM 10 TABLET NOVO-SALBUTAMOL HFA 100MCG/DOSE APO-HYDRO 12.5MG TABLET MYLAN-OMEPRAZOLE 20MG DR CAPSULE TOLOXIN 0.125MG TABLET APO-TRAMADOL/ACET 37.5/325MG TABLET APO-ROSUVASTATIN 10MG APO-ROSUVASTATIN 20MG TABLET APO-ESOMEPRAZOLE 40MG TABLET CO ROSUVASTATIN 10MG TABLET CO ROSUVASTATIN 20MG TABLET SANDOZ TAMSULOSIN CR 0.4MG ER TABLET MYLAN-NIFEDIPINE 30MG ER TABLET RATIO-ATORVASTATIN 10MG TABLET RATIO-ATORVASTATIN 20MG TABLET VICTOZA MULTIDOSE PEN INJECTOR AMOXICILLIN 500MG CAPSULE METFORMIN 500MG TABLET TEVA-ROSUVASTATIN 10MG TABLET TEVA-ROSUVASTATIN 20MG TABLET DEXILANT 60MG CAPSULE SANDOZ-VALSARTAN 80MG TABLET SANDOZ-VALSARTAN 160MG TABLET PRADAX 150MG CAPSULE VIMOVO 500MG/20MG TABLET PATADAY 0.2% OPH SOLUTION APO-CANDESARTAN 16MG TABLET PANTOPRAZOLE 40MG TABLET SANDOZ TELMISARTAN 80MG TABLET PMS-ROSUVASTATIN 10MG TABLET RAN-ROSUVASTATIN 10MG TABLET METHADONE SOLUTION ODB ONE TOUCH ULTRA BLUE TEST STRIP (ON) CONTOUR TEST STRIP (ON) 02298082 02298392 02298457 02298538 02298546 02298589 02301083 02301482 02301490 02303671 02303922 02305046 02310538 02310546 02314185 02314908 02315963 02318695 02321092 02321157 02321653 02325462 02326450 02327856 02329433 02335719 02336790 02337983 02337991 02339102 02339773 02339781 02340208 02349167 02350297 02350319 02351064 02352729 02353377 02354616 02354624 02354969 02356759 02356767 02358808 02361728 02362171 02365367 02370808 02375966 02378531 02382652 09850619 09854290 09857127 Listed Y 50% Y Y Y Y Y Y 50% 50% 50% Y 50% 50% Y Y Y Y 50% 50% 50% Y 50% Y Y Y 50% Y 50% Y Y 50% Y Y Y Y Y Y 50% Y Y Y Y 50% Y Y 50% 50% 50% Y 50% Y Y Y Y Y Y